title: Timing and magnitude of serum creatine kinase-MB after transcatheter cardiac tissue fulguration in man.
abstract: This study examined the impact of transcatheter fulguration on creatine kinase-MB release in 21 patients (age range 17-71 years). Arrhythmia diagnoses were ventricular tachycardia 9, atrial fibrillation with a rapid ventricular response 7, atrioventricular nodal reentry 2, and reciprocating tachycardia utilizing a posteroseptal accessory pathway 3. Seven patients had apparently normal hearts while 8 had ischemic heart disease and 6 cardiomyopathy. Timing of initial elevated creatine kinase-MB activity (mean 1.34 +/- 0.69 SD hours) and peak creatine kinase-MB activity (mean 3.73 +/- 0.89 SD hours) was relatively uniform in all patients. Time to peak creatine kinase-MB activity was unrelated to either underlying cardiac disease (normal: 3.9 +/- 1.0 hours; ischemic heart disease: 3.5 +/- 0.9 hours; cardiomyopathy: 3.8 +/- 0.9 hours), or fulguration site (His bundle (n = 9): 4.2 +/- 0.9 hours, proximal coronary sinus (n = 3): 3.3 +/- 0.3 hours, ventricle (n = 9): 3.4 +/- 0.8 hours). The magnitude of peak serum creatine kinase-MB activity was independent of myocardial diagnosis or fulguration site, but was linearly related to total energy delivered (r = 0.5, P less than 0.022). The latter correlation was particularly strong within cardiac diagnosis subgroups (normal: r = 0.92, P less than 0.002; ischemic heart disease: 0.73, P less than 0.04; non-ischemic cardiomyopathy: r = 0.57, P = NS). Thus, serum creatine kinase-MB activity following transcatheter fulguration is linearly related to the magnitude of delivered energy, and is similar to that observed after transient coronary artery occlusion and reperfusion.
authors.affiliation: Department of Medicine, University of Minnesota Medical School, Minneapolis.
authors.forename: J
authors.initials: J
authors.lastname: Lesser
authors.forename: I F
authors.initials: IF
authors.lastname: Goldenberg
authors.forename: S
authors.initials: S
authors.lastname: Milstein
authors.forename: A
authors.initials: A
authors.lastname: Dunnigan
authors.forename: D
authors.initials: D
authors.lastname: Dunbar
authors.forename: C C
authors.initials: CC
authors.lastname: Gornick
authors.forename: W
authors.initials: W
authors.lastname: Reyes
authors.forename: D G
authors.initials: DG
authors.lastname: Benditt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000201:enzymology / Q000628:therapy*; D006328:Cardiac Catheterization; D003402:Creatine Kinase / Q000097:blood*; D004554:Electric Countershock; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase